Groan. Faced with a fabulous buffet, I overindulged… and paid for it with a few hours of heartburn. I’m guessing that most of us have that experience occasionally. But an estimated 20% of Americans have a chronic form of heartburn — characterized by chest pain, a persistent cough and/or burning at the back of the throat that occur more than twice weekly — known as gastroesophageal reflux disease (GERD). Besides causing significant discomfort, if left untreated, this condition increases the risk for esophageal cancer.
So it was unwelcome news when a recent article in the Canadian Medical Association Journal confirmed that two types of stomach-acid-reducing drugs commonly used to treat GERD are linked to increased risk for pneumonia. Long-term use of these drugs — proton pump inhibitors (such as Prilosec and Prevacid) and H-2 blockers (such as Tagamet and Zantac) — also is linked to impaired nutrient absorption… increased risk for hip fractures, high blood pressure and heart attack… and perhaps reduced effectiveness of the blood thinner clopidogrel (Plavix).
Fortunately: Drugs are not the only way to deal with GERD. Kristina Conner, ND, an assistant professor at National University of Health Sciences in Lombard, Illinois, who specializes in women’s health and digestive problems, told me about various natural therapies that ease or eliminate GERD.
Before we get into those, let’s quickly review a bit of biology. To break down food, the stomach produces about one quart of hydrochloric acid daily. At the base of the esophagus is the lower esophageal sphincter (LES), a band of muscle that opens to let swallowed food into the stomach, then shuts again. When the LES fails to close properly, stomach acid backs up into the esophagus and damages the esophageal lining. This is what happens with GERD. What helps…
Taken alone or in combination for two to four months, the dietary supplements below promote esophageal healing, Dr. Conner said. For dosages and guidelines on which supplements are most appropriate for you, consult a naturopathic physician. Options…
- Calcium citrate powder mixed with water helps tighten the LES and improves the esophagus’s ability to push acid back into the stomach.
- Deglycyrrhized licorice tablets promote production of mucus that protects esophageal cells.
- Marshmallow root lozenges contain mucilage, a gelatinous substance that coats the gastrointestinal tract, soothes inflammation and heals cells lining the esophagus and stomach, Dr. Conner said.
- Slippery elm herbal tea also provides mucilage. Drink it hot, not iced. Warm beverages are easier to absorb than cold drinks, which can tax gastrointestinal function, Dr. Conner pointed out.
- Vitamin B complex, including thiamine (B-1), pantothenic acid (B-5) and choline, promotes proper smooth-muscle activity of the esophagus to keep food moving in the right direction.
Foods that can exacerbate GERD by relaxing the LES muscle and/or increasing acidity generally are those that are spicy or high in fat or sugar. Some people find that symptoms are triggered by certain other foods, such as alcohol, carbonated beverages, citrus fruits and juices, chocolate, coffee, mint, onions and tomatoes. Contrary to the popular idea that dairy foods ease GERD, they actually can worsen symptoms. “You do not necessarily need to give up all these foods forever, but you will feel better if you avoid them long enough to let your body recover,” Dr. Conner said.
What to do: Eliminate all potential troublemakers from your diet for two to four weeks, then reintroduce them one at a time. If eating a particular food brings on symptoms within a day, avoid it for another three to six months, then try it again. If GERD symptoms return, it is best to avoid this food henceforth. If no symptoms develop after the three- to six-month hiatus, you may be able to eat this food occasionally. But keep portions moderate. “You can’t drink eight cups of coffee or soda per day and expect GERD not to return,” Dr. Conner noted.
Safe to eat: Foods unlikely to exacerbate GERD include those that are high in fiber, complex carbohydrates and/or minerals, Dr. Conner said. Good choices include most fruits and vegetables (except those identified above as potential heartburn triggers)… lean meats and skinless poultry… and whole grains.
Eat slowly and chew carefully, giving your mouth — a key part of your digestive system — and stomach plenty of time to work. Don’t overfill your stomach. “Avoid eating while watching TV, driving, standing up or doing anything that takes attention away from your food and encourages you to rush or overeat,” Dr. Conner said. Celebrate your food: Put out placemats, cloth napkins, even candles… as you eat, notice each food’s taste, texture and aroma. You’ll enjoy your food more and eat less — a double benefit.